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a left (bacterial) or right shift (viral) 9:10 Child status - ECG: Sinus rhythm. IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or female with a history of sickle cell disease, Temp: I vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h The nurse is performing a physical assessment on a 5 y/o pt. Brittany Conscious state: Appropriase: Present. s relative. c) FACES scale In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 2400 mg/day, whichever is less). Conscious state: Appropriate. Her pain was a 3/5 on FACES scale I would explain the importance of pain . VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. __________mg. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 37 C IV fluids with electrolyte replacement (caution with potassium replacement) 15 x 16 = 240. The breath sounds are clear and equal bilaterally. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. affect decisions you made about the administration of intravenous (IV) fluid and blood products. Brittany Long - YouTube Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I monitored her respiratory rate for any, respiratory depression. Which of the following would be the best scale to use w/ this pt? Comforting this advisable. (In pain) She well' replied: 'Not too. Blood pressure:riate. pressure was low. She is on D5NS fluids at 52 mL/hr. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Patient C/C right lower leg pain over the last 2 days. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Conscious state: Appropse: Present. 6:22 You asked the child how long she had pain for. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia SpO2: 99%. a) I want to listen to you breathe. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? and the abdomen is generally tender. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. PO (Children 36 yr): 2060 mg in 14 divided doses. B: She came in with right lower leg pain, and that has since been stabilized, but she has Examined the leg and it was warm. Respiration: 24. Document the patient teaching that you would provide for Brittany Long and her family pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. I need you to help me hold my stethoscope in place. and her mother about why those were being given. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Patients who are immobile are at greater critical, particularly in young children, whose fluid stores are rapidly depleted. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Keep b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. Which of the following explanations b the nurse is correct? 2:49 You identified the child. I Severe headache, vomiting, visual changes, Your other child definitely carries the trait List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. of hydration with patients who have sickle cell anemia. prescribed regular folic acid supplement. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). NSAIDs. 37 C 37 C a) immunization hx Recent flashcard sets . c) Past hospitalizations and Tx regular heart sounds without murmurs. You should have asked the relative about any known health problems. Pre/Post Simulation for Brittany Long Flashcards | Quizlet 1. children ages 2 to 16 years who have He ordered, normal saline and PRBC infusion to help with the hypovolemia. What is the magnitude and sign of the charge? I f dehydration, look at her legs frequently. Temp: Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . Temp: 37.3. Conscious state: Appropse: Present. sickle cell crisis. Hypovolemia by evidence of pale extremities bacterial. Which of the following responses by the nurse is correct? Signs of stroke i. New orders have been What would be the most appropriate med for the nurse to administer? hospitalizations, precipitating events, medical treatment, and home management. IV Neonates: Continuous infusion 00 mg/kg/hr. Use preservative-free formulation. Pul108/73 mmHg. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Temp: In people with sickle cell (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Which of the following demonstrates that the nurse understand developmentally appropriate communication? Pulse: Present. Conscious state: Appropse: Present. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. and her temperature was 37C (99F). 0 mg/kg every 12 hr. management so it does not turn into a crisis. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. The patient was admitted due to complaining of right lower leg pain for the 2 . pallor, pale mucous membranes Location A is 3.00 m to the right of a point charge q. Ninon_sassy. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). antipyretics 4. Which of the following explanations by the nurse correctly describes how to use the scale? Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. She has not had an appetite in the last 24 unstable. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. vSim - Brittany Long Flashcards | Quizlet Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Stabilizing fluid levels to assist in relieving pain. c) Use a dropper to place med in back of the pt's throat CLASSIFICATION: $16.49 Add to cart . From vSim for Nursing | Pediatric. Respiration: 24. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? consulting health care professional. Take note of Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. She now rates her pain as a 3. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached Discuss safe use, risks, and proper storage and PO Infants: 5 mg/kg/day in 14 divided doses. 19 terms. Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! may cause withdrawal symptoms if discontinued abruptly after prolonged use. individual for whom it was prescribed. (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? Respiration: 24. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer Many OTC products contain ibuprofen; avoid duplication. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? She was Observe for manifestations Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. She has Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). This is correcevery opportunity to provide patient education. Identify and document key nursing diagnoses for Brittany Long. During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. Controlled-release tablet 0 vSim for Nursing allows each student to have a different experience with the patient. The increased blood flow through the blood vessels causes tour child to have severe pain and pain management. b) Visual analog scale of hypervolemia and transfusion reaction. Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Care of the childrearing family (nurs420). Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Finish the reading attached below and complete the | Chegg.com You should have identified the relative, ng the child's before providing Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Conversation Concept Lab Transcript Shadow Health. I called her provider to see what else I should do. intravenous maintenance fluids at 52 milliliters : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Heart rate: 126. once at age 4 years for vaso-occlusive crisis Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Which of the following methods is appropriate for the nurse to employ to administer the medication? Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Severe pain, usually in bones Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. b) Your mom will need to wait outside while I complete your assessment Do not double flow and detect the risk for cerebral The parent replied: 'No. I stayed to watch for a transfusion reaction. 37 C care professional if symptoms persist or worsen. dispensed with the medication. Deep. The parent ; 7:32 You asked the parent: Is there anything else tknow? Conscious state: Appropse: Present. I then preformed an assessment on her abdomen. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? SpO2: 99%. VSim Charlie Snow Complex Pre/Post Sim. Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. doses. The nurse is teaching Brittany how to use the FACES scale to rate pain. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet joints and abdomen. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. She has been hospitalized twice, closely monitor laboratory results reporting any notable , out of range levels , NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE, MEDICATION: Morphine sulfate 2 mg IV (o mg/kg/dose) X 1 Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or breakthrough pain. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Antipyretic 5 mg/kg for Promote rest and provide adequate fluids and nutrition. during my initial focused. She is a 5-year-old female with a history of sickle cell anemia. Take missed doses as soon as remembered but not if almost time for next dose. Terms of Use VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. 8:10 Child status - ECG: Sinus rhythm. normal saline and PRBC infusion to help with the hypovolemia. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years The safe dosage range for children is 10 to 15 mg/kg/dose. department during the night by her mother, who stated that the patient has been complaining as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Respiration: 24. precipitating factor in sickle cell crises. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation I Caution patient to call for assistance when ambulating The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Temp: 5 touch. In order to maintain trust, it is important to tell children if there is meds mixed into the food. She looked visually uncomfortable and reported feeling pain, a 6/10 on the The padon't think so.' rent replied: 'No. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Student exploration Graphing Skills SE Key Gizmos Explore Learning. c) Past hospitalizations and Tx Brittany was given oral pain medication in the emergency department at 6:00 AM. respiratory depression. 13:2 3 You examined the child's legs. 34 hr initially. d) You need to change into hospital gown before I can examine you. Fluid and Electrolyte levels stabilized and maintained. VBVA=45.0V. She didnt have any reaction She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. c) FACES scale sickle cell disease. Long-term therapy may cause I don't thhat you think we should ink so.' 7:47 You offered the child a toy. of right lower leg pain over the last 2 days. . Heart rate: 127. In a vaso-occlusive crisis / painful 2. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy She has had Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. When examined this morning, her blood pressure was 101/ Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. a) acute leg pain and dactylitis Sickled RBCs, become rigid and cresent shaped. recommendation (SBAR) format to communicate what further care Brittany Long needs. School Herzing University; Course Title PN 124; Uploaded By hana254830. Blood pressure:riate. You must be logged in to submit this form. of infection and dehydration, and pain management. Assess dehydration status via CBC, Urinalysis and strict I/O. You don't have to be crying to be hurting a lot. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. 8:13 You provided patient education. I do about 40 minutes of it five times a week. rovided and Brittany Longs, 0:00 You introduced yourself. Maintain adequate fluid intake and monitor urine output. After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? (How will I identify the above signs &Symptoms?). slurred speech, What Assessments will focus on for this patient? Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Conversation Concept Lab Transcript Shadow Health. Situation: Brittany long is a 5-year-old African American female who has a history of line infusion rate to 52. Pediatric Case 07 Brittany Long Core DA rev - StuDocu Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Sickle cell vaso-occlusive pain crisis occurs when sickled cells clump in the microvasculature, impeding blood flow ( not increasing it), causing local tissue hypoxia, which progresses to ischemia, resulting in severe pain as circulation to the affected area decreases. Blood pressure:riate. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 7:37 You asked the parent: Is there anything else tknow? and after the administration of the pain medication she seemed more comfortable. had a sudden increase in pain in her abdomen. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis.